Skin cancer is as easy as A-B-C . . . and D . . . and E

May is Skin Cancer Month and Monday, May 2 is “Melanoma Monday” so let’s talk about your skin. You probably have heard many times about many types of illness – “Catch it early and it is really treatable but catch it late and it’s pretty serious.” Well, that is really true for skin cancer, particularly the scary one – melanoma.

So knowing a bit about preventing and detecting skin cancer could quite literally save your life. I hope to give you some tools to do so here. When preparing for this topic, I found just an enormous amount of information floating around the Internet, most of it quite solid but some of it frankly dangerous in its inaccuracy. For instance, there are some cringe-worthy sites out there claiming you can cure skin cancer by applying some salve you bought on the Internet. (No, you can’t).

So I’ll try to limit this to the two key areas of prevention and detection. We’ll leave treatments and so forth to another time. To help, I’ll rely on two of my colleagues who joined me on the Healthy Matters broadcast this week and also point you toward reliable and easy-to-use interactive resources from some trustworthy sources. Click the logo at left to access the podcast from the radio broadcast. Maybe listen to it while you are reading this post!

Facts about melanoma

Melanoma is the deadliest form of skin cancer since it can spread to other areas of the body if left untreated.

When detected early there are good treatments for melanoma.

Some people are at higher risk of melanoma: those with relatives who had melanoma, fair-skinned people, blonds and redheads to name a few.

Even so, people of all skin colors can get melanoma.

Yes you have to wear sunscreen . . . or get a really big hat

Dr. Jenny Liu

My guests on the radio show this week were Drs. Erin Luxenberg and Jenny Liu, both dermatologists at Hennepin County Medical Center. Of course we had to talk about protecting your skin from the harmful UV rays from the sun, since sun exposure is a big risk factor for getting skin cancer later in life.

Dr. Erin Luxenberg

Of the big three skin cancers, basal cell and squamous cell carcinoma have a strong link to sun exposure whereas melanoma risk is increased with sun exposure but can also appear on non-exposed areas of the body. This is good to know so that you check your whole body for skin cancers, not just your face and arms.

So what is the scoop on sunscreen and how does it work?

Dr. Liu helped us distinguish between the two main types of sun protection: chemical and physical.

To understand how chemical sunscreens work it helps to know a bit of chemistry. Stick with me here, don’t start daydreaming just like you did in high school chemistry class (admit it – you did that!) When the UV rays of the sun hit your skin, the energy has a destructive tendency to break up your molecules and DNA. Since skin cells are dividing rapidly all the time, destroying your DNA may end up with some of the future skin cells going haywire. Cancer results.

Chemical sunscreens work by absorbing the harmful UV rays from the sun, and through a simple chemical reaction in your skin, they convert some of the harmful energy into heat which simply radiates away from your skin.

Physical barrier sunscreens work a different way. These are the inorganic types which usually contain zinc oxide or titanium dioxide. They don’t cause a chemical reaction; instead they simply reflect the UV rays out from your skin rather like a mirror. In the old days these types of barrier sunscreens looked basically like white paint. Not real attractive on the beach. Remember the old lifeguards with white noses? More modern forms are clear but still work the same way.

Dr. Luxenberg told us that the physical barrier sunblocks are preferred in many cases – like for children. They often are marketed with names containing “for sensitive skin” or some such wording. But regardless of what type you use, you need to apply a lot more than you think and more often than you think and earlier than you think.

I get the sense most dermatologists are big customers for hat makers. Dr. Luxenberg recommended the kinds with big brims. Or ear flaps. She’s obviously got a real sense for fashion, I think.

And we even talked baseball caps. You may look cool like this guy but better put sunscreen on your ears.

But in all seriousness they are right. Wear a hat.

Detection: learn your ABCs

OK so we covered prevention. Now onto the second take-home point: detection. Check out this video:

Since just about every one of us has a mole somewhere or other it can be tough to know when it is something to be concerned about. I bet it is a question dermatologists hear every single day. “Is this spot something I need to worry about?”

Here is where ABCDE comes in. It is a useful memory-aid to use to decide if something is worrisome. Here’s what it means.

A = Asymmetry. One side of the mole doesn’t look like the other side. Perfectly round symmetric spots are less worrisome.

B = Border. The borders of the mole are irregular or jagged.

C = Color. Worrisome lesions sometimes have a variety of colors in them; they may not be uniformly all one color.

D = Diameter. Bigger is more concerning – for instance, larger than a pencil eraser.

Keep in mind these are not absolutes. In other words, a cancerous skin lesion may not have any of the ABCDE characteristics. But it is a good starting place when looking at a bump on your own skin. If your mole or spot has any of the ABCDEs, then get it checked out by a dermatologist. To be perfectly candid, this is exactly what I do as a primary doctor when evaluating a mole on a patient. I apply the ABCDE rule and if one or more of those things is present I refer them to a dermatologist. You should do the same.

Watch the short video here for more on checking your skin. It has good pictures of how to use the ABCDE tool.

The two things I hope you take away from this post is the importance of PREVENTION and DETECTION of skin cancers.

For more information about skin cancers, the following sites have really good tips and resources that you can trust.

That’s crazy that melanoma can occur anywhere on the body and that someone is dying from it every hour. It’s a bit sad to think about but crazy. It just goes to show how fragile we are when it comes to being exposed to the sun. I should really be more mindful and wear sunscreen and perhaps meet with a doctor who can check my skin for any possible spots of skin cancer.

Wow, I had no idea that someone dies from melanoma as often as every hour; that’s pretty intense. I have a mole that I think may actually be melanoma, and while I have been considering getting it checked by a dermatologist, the fact that melanoma is the deadliest form of skin cancer makes me feel a greater sense of urgency about it. The fact that melanoma can appear on parts of the body that aren’t exposed is frightening, to be sure, and I’ll definitely get checked out by a professional soon.